Síndrome pulmón-riñón en lupus severo asociado a ANCA: ¿un síndrome de sobreposición?

We report the case of a woman of 30 years, Mexican, who after spending without renal lupus activity data for 13 years after diagnosis, without chronic immunosuppression, experienced a general decline for severe autoimmune condition triggered after an uncomplicated term pregnancy presenting even diffuse alveolar hemorrhage in 2 occasions within 12 months, in the context of Anti neutrophil cytoplasmic ANCA (+), becoming its handling difficult from the point of view of therapeutic immunosuppression regimens triple and quadruple. During its evolution has developed cerebral microangiopathy and laryngitis which raises the possibility of an overlap syndrome lupuserythematosus - ANCA associated vasculitis, an entity not well described in the literature, whose diagnosis is fraught with difficulties in the absence of defined criteria or true ANCA involvement in a patient with lupus.